• Journal of Korean Public Health Nursing
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• v.34 no.2
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• pp.251-262
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• 2020

Purpose: This study attempts to provide basic data for establishing and implementing an advanced directive (AD) system that helps identify dignified death attitudes and reduces death anxiety of the preliminary, through preparation of an AD. Methods: Data were collected from 135 preliminary elderly aged 55 to 64 years, recruited from health centers and welfare facilities. All data were analyzed using SPSS 22.0. Results: Overall scores of the participants were 2.26±0.64 for death anxiety scale, and 3.16±0.44 for dignified death attitude. Scores of individuals who prepared an AD were determined to be 2.19±0.64 for death anxiety, and 3.34±0.44 for dignity of death. The difference in scores obtained for dignified death attitude was significantly higher for the group that signed an AD, as compared to the group with no AD (F=14.81, p<0.001). Conclusions: Results of this study reveal that preliminary elderly who sign an AD have a higher dignified death attitude score as compared to subjects who do not sign an AD. Additionally, the former group of participants desire a dignified end to their life. This indicates a necessity to promote public campaigns for ADs, and to develop educational programs that assist the elderly to prepare for a dignified death and make autonomous decisions.

• Korean Journal of Adult Nursing
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• v.23 no.5
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• pp.482-493
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• 2011

Purpose: This study was conducted to compare and identify the mediating effect of family communication in the impact of death anxiety and personal meanings of death on the attitude of dignified death near the end-of-life among Korean mid-life and old people. Methods: A cross-sectional study was conducted with 287 mid-life and old people in Seoul, Busan, and Daegu City. Data were collected through self-report questionnaires which were standardized instruments from November 2010 to March 2011. Data were analyzed by using SPSS/WIN 14. Results: The results of the study indicated that there were statistically significant differences in level of death anxiety, personal meaning of death, and the dignified death between mid-age and old-age people. In addition, family communication had full mediating effects among the mid-age, while it had partial mediating effects among the old-age in the relationships between death anxiety, personal meaning of death, and the attitude of dignified death. Conclusion: Based on the findings of the study, implications for the intervention of the dignified death and preferences for care near the end-of-life among mid-life and old people and recommendations of further study were provided.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.1
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• pp.72-82
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• 2010

Purpose: The purpose of this study is to understand the meaning of dignified dying expressed by undergraduate nursing students. Method: Data were collected by in-depth interviews with fifteen nursing students. Conventional qualitative content analysis was used to analyze the data. Result: There were six major themes and eleven sub-categories from the analysis. Six major themes include death with no artificial life support, obedient death as a human nature, death with family members, meaningful death, no self destructive death, and sympathized death receiving from health care providers. Conclusion: The result of this study suggests that the nursing curriculum related to dignified dying can be developed and may affect the teaching and learning settings to improve end-of-life care performance among undergraduate nursing students, as well as, students in human service areas and health care providers.

• Journal of Korean Clinical Nursing Research
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• v.26 no.1
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• pp.86-96
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• 2020

Purpose: The purpose of study was to provide basic data for developing interventions that could help middle-aged adults prepare for dignified death in the future by examining their attitudes toward death and advance directives (AD), and knowledge of AD. Methods: Data were collected through a survey of 211 middle-aged adults from January 28 to February 28, 2019, in a city located in Gangwon Province. To analyze the data, descriptive statistics, t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient and stepwise linear regression were utilized using SPSS/WINdows 21.0. Results: The average score of the participants' attitudes toward death and AD, and knowledge of AD was 91.82±10.89, 15.53±4.27, 46.00±9.45, respectively. There were positive correlations between attitudes toward dignified death and attitudes toward AD, and knowledge of AD. Factors that influence attitudes toward AD were shown in the order of attitudes toward dignified death, knowledge of AD, and intentions to write AD (Adjusted R²=.24). Conclusion: For the dignified death in the future, it is necessary to provide middle-aged adults with an opportunity to think about the need of AD. In addition, extensive education and promotion of AD are required to correct the misunderstanding of AD.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.223-231
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• 2013

Purpose: This study was conducted to explore how nurses' attitude toward dignified death and moral sensitivity affect their end-of-life care performance. Methods: Study participants were 172 nurses who work at university hospitals in a metropolitan city in Korea. Data were collected from June 20 through August 13, 2012 using the Dignified Death Scale, Moral Sensitivity Scale, and End-of-Life Care Performance Scale. Data were analyzed using the SPSS/WIN 19.0 program. Results: Factors affecting nurses' end-of-life care performance included moral sensitivity, dignified death and education level. Conclusion: Moral sensitivity, dignified death and education level should be considered when developing an educational program for nurses' end-of-life care performance.

• Journal of Digital Convergence
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• v.18 no.10
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• pp.353-359
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• 2020

Purpose: The purpose of this study was to identify the effects of suffering experience, self-forgiveness and emotional expression of loss on nurses' attitude toward dignified death. Methods: The subjects in this study were 140 nurses, had been working over 6 months in a general hospital. Data were collected from July 1 to August 31 2016, by using self-reported questionnaires. Data were analyzed using the IBM SPSS 19.0 programs. Results: The significant predictors that affected nurses' attitude toward dignified death were experience of suffering, emotional expression of loss, religion and educational level. The explained variance for nurses' attitude toward dignified death was 63.9% and the most significant factor was emotional expression of loss. Conclusion: These results suggest that attitude toward dignified death of nurses can be changed positively by communicating emotional expression of loss and their suffering experience.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.95-100
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• 2023

With the implementation of Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life, interests of the general public on self-determination right and dignified death of patients have increased markedly in Korea. However, "self-determination" on medical care is misunderstood as decision not to sustain life, and "dignified death" as terminating life before suffering from disease in terminal stage. This belief leads that physician-assisted suicide should be accommodated is being proliferated widely in the society even without accepting euthanasia. Artificially terminating the life of a human is an unethical act even though there is any rational or motivation by the person requesting euthanasia, and there is agreement thereof has been reached while there are overseas countries that allow euthanasia. Given the fact that the essence of medical care is to enable the human to live their lives in greater comfort by enhancing their health throughout their lives, physician-assisted suicide should be deemed as one of the means of euthanasia, not as a means of dignified death. Accordingly, institutional organization and improvement of the quality of hospice palliative care to assist the patients suffering from terminal stage or intractable diseases in putting their lives in order and to more comfortably accept the end of life physically, mentally, socially, psychologically and spiritually need to be implemented first to ensure their dignified death.

• Korean Journal of Adult Nursing
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• v.22 no.2
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• pp.130-142
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• 2010

Purpose: The purpose of this study was to analyze attitude toward dignified dying of Korean students majoring in human service area. Methods: The Q-methodology which provides a method of analyzing the subjectivity of each item was used. The 34 selected Q-statements from each of 38 subjects were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program. Results: Four types of attitude toward dignified dying from the subjects were identified. Type I is an expression type for happy emotion, Type II is a dislike type for life prolongation, Type III is a pursuit type for relationship improvement, and Type IV is a perception type for family presence. Conclusion: The results of the study indicate that integrating multi-disciplinary curriculum development related to dignified dying and death education for students majoring in human service area are needed.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.80-94
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• 2023

Purpose: This study aimed to identify attitudes toward advance directives (ADs) among female cancer patients and factors related to ADs. Methods: The study was conducted at a university hospital in Seoul from September 19, 2020, to January 20, 2021. The participants were 153 patients diagnosed with gynecological cancer or breast cancer. Data were collected using questionnaires and included general characteristics, disease- and AD-related characteristics, knowledge and attitudes about ADs, and attitudes about dignified death. Data were analyzed using the t-test, analysis of variance, and multiple regression analysis. Results: Only 2% of the participants completed ADs. The mean score for attitudes toward ADs was 3.30, indicating a positive knowledge and attitude toward dignified death. The factors related to attitudes toward ADs were attitudes toward dignified death (𝛽=0.25, P=0.001), experience discussing life-sustaining treatment (𝛽=0.17, P=0.037), preferred time to have a consultation about ADs (𝛽=0.19, P=0.046), intention to write ADs (𝛽=0.15, P=0.038), and Eastern Cooperative Oncology Group Performance Status (𝛽=-0.37, P<0.001). The explanatory power of these variables for attitudes toward ADs was 38.5%. Conclusion: Overall, patients preferred to have a consultation about ADs when they were still active, mentally healthy, and able to make decisions. Education about ADs should be provided to patients on the first day of hospitalization for chemotherapy or while awaiting treatment in an outpatient setting so patients can write ADs and discuss them with family and friends.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.5 no.2
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• pp.237-256
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• 1998

Death and dying of human being is a comprehensive system, and death orientation, the subjective meaning related to every component of the death system is developed throughout life. This study was designed and carried out to identify, describe and classify the orientations of Korean adult towards the death system. In an attempt to measure the subjective meaning of death and dying, unstructured Q-methodology was used. The 65 Q-statements developed by Kim(1994), used by Kim(1994) and Park(1996) were adopted as Q-population and 39 Q-statements were selected by the three researchers for Q-items for this study. Thirty-three P-samples were sampled from P-population of literate Korean men and women, 35 and 55 years of age, lived in urban Korea for the last 10 years. Sortings of the 39 Q-items according to the level of personal agreement, and a forced normal distribution into the 9 levels were carried out by the P-samples. The Z-scores of the Q-sort data were computed, and the principal components factor analysis by PC-QUANL Program were carried out. The demographic, socio-cultural and health-related attributes of the P-samples were descriptively analysed. Eight types of death orientation were identified ; Type I ; 'naturalist'. Six P-samples. Death is a natural phenomena, to be accepted as it is and to follow its natural course. Prefer to be informed of all facts and possibilities concernig the course of dying and death to occur to self. Type II ; 'life-after-life negator'. Three P-samples. Time and process of death is the destiny of each person. Death means 'darkness' and 'end to every thing, the absolute end'. Yet, wish physical integrity at the dying and after death. Type III ; 'life-after-life believer'. Six P-samples. Men are travellers passing by this life bound to the life-after-life. Priority concerns are on the activities to prepare self for the eternal life ahead. Disregard premature and sudden death. Type IV ; 'here-now believer' Five P-samples. Positive regard to the cremation of the body and donation of the organs on death. Regard religious and customary post-motem rituals meaningless. Negate life-after life. Type V; 'believer of rituals'. Five P-samples. Death being accepted as a part of, a natural end to, and destiny of human life. Concerned to ensure a dignified end to personal life and dignified post-mortem rituals. Type VI ; 'Realist'(derived from Type I). Two P-samples. Life and death as universal reality. The abrupt death at golden age at the peak of happiness is favored to avoid inevitable physical and mental distress of self and the family. Agreed to the cremation of the body. Disregard rituals. Type VII : 'Fatalist' (derived from Type II). Five P-samples. Not favored, yet, all man are destined to death, the inevitable end of all living beings. To ensure dignified end by personal consummation, information on one's dying and imminent death are to be shared. Type VIII ; 'reality avoider'(derived from Type III). One P-sample. Negative to longevity, artificial prolongation of, meaningless and distressful life. Highly positive to postmortem organ donation.